Abstract
Abstract TMP6: Dural Arteriovenous Fistulas With Cognitive Impairment: Angiographic Characteristics and Treatment Outcomes
Stroke (1970), Vol.55(Suppl_1)
02/2024
DOI: 10.1161/str.55.suppl_1.TMP6
Abstract
Abstract only Background: Anecdotal cases of rapidly progressing dementia in patients with dural arteriovenous fistulas (dAVFs) and cortical venous drainage have been reported in small series. However, a comprehensive description of the angiographic features of this dAVFs is lacking. We conducted an analysis of the largest cohort of dAVFs presenting with cognitive impairment (dAVFs-CI), aiming to provide a better characterization of this subset of dAVFs. Methods: The CONDOR Consortium, a multicenter repository comprising 1077 dAVFs, served as the study population. Among the dAVFs, patients with dAVFs-CI were analyzed. A propensity scores matching analysis was conducted to compare dAVFs-CI with Borden type II and type III dAVFs without cognitive impairment (controls). Logistic regression was employed to identify angiographic characteristics specific to dAVFs-CI. Post-treatment outcomes were analyzed. Results: A total of 60 patients with dAVFs-CI and 60 control dAVFs were included. Outflow obstruction leading to venous hypertension was observed in all dAVFs-CI. Sinus stenosis was significantly associated with dAVFs-CI (OR 2.85, 95% CI: 1.16-7.55, p = 0.027). dAVFs-CI were more likely to have a higher number of arterial feeders (OR 1.56, 95% CI 1.22-2.05, p < 0.001) and draining veins (OR 2.05, 95% CI 1.05-4.46, p = 0.004). Venous ectasia increased the risk of dAVFs-CI (OR 2.38, 95% CI 1.13-5.11, p = 0.024). A trend toward achieving asymptomatic status at follow-up was observed in patients with successful closure of dAVFs (OR 2.86, 95% CI 0.85-9.56, p = 0.09). Discussion: Venous hypertension is a key angiographic feature dAVFs-CI. dAVFs-CI exhibit a complex angioarchitecture characterized by an increased number of arteriovenous connections and stenosed sinuses. The presence of venous ectasia further exacerbates the impaired drainage and contributes to the development of dAVFs-CI. Notably, closure of the dAVF has the potential to reverse symptoms in certain cases (Figure).
Details
- Title: Subtitle
- Abstract TMP6: Dural Arteriovenous Fistulas With Cognitive Impairment: Angiographic Characteristics and Treatment Outcomes
- Creators
- Sebastian Sanchez - University of IowaDiego Ojeda - University of IowaElena Sagues - University of IowaAndres S Gudino - University of Iowa Hospitals and ClinicsArshaq Saleem - Univ of Iowa Carver College of Medicine, Iowa City, IALinder Wendt - University of Iowa Hospitals and ClinicsMinako Hayakawa - University of IowaChing-Jen Chen - The University of Texas Health Science Center at HoustonJason Sheehan - University of Virginia Health SystemLouis Kim - University of WashingtonIsaac Abecassis - Seattle UniversityMichael Levitt - Seattle UniversityR Michael Meyer - Seattle UniversityRidhima Guniganti - Washington University in St. LouisAkash P Kansagra - Washington University in St. LouisGiuseppe S Lanzino - Mayo Clinic in ArizonaEnrico Giordan - Mayo ClinicWaleed Brinjikji - Mayo Clinic in ArizonaDiederik Bulters - University Hospital Southampton NHS Foundation TrustAndrew Durnford - University Hospital Southampton NHS Foundation TrustW Christopher Fox - Mayo Clinic in FloridaJessica Smith - University of FloridaAdam Polifka - University of FloridaBradley Gross - University of PittsburghSepideh Amin-Hanjani - University of Illinois Urbana-ChampaignAli Alaraj - University of Illinois ChicagoAmanda Kwasnicki - University of Illinois ChicagoRobert Starke - University of MiamiStephanie H Chen - University of MiamiJ Marc C van Dijk - University of GroningenAdriaan R Potgieser - University of GroningenJunichiro Satomi - Tokushima UniversityYoshiteru Tada - Tokushima UniversityRyan Phelps - University of California, San FranciscoAdib Abla - University of California, San FranciscoEthan Winkler - University of California, San FranciscoRose Du - Brigham and Women's HospitalPui Man Rosalind Lai - Brigham and Women's HospitalSantiago Ortega-Gutierrez - University of IowaGregory J Zipfel - Washington University in St. LouisColin P Derdeyn - University of IowaEdgar A Samaniego - University of Iowa
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.55(Suppl_1)
- DOI
- 10.1161/str.55.suppl_1.TMP6
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 02/2024
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984557959602771
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